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公开(公告)号：US5743874A
公开(公告)日：1998-04-28
申请号：US298214
申请日：1994-08-29
CPC分类号： A61M25/104 , A61F2/95 , A61F2/958 , A61F2/966 , A61M2025/0183 , A61M2025/1079
摘要： A single, integrated catheter is capable of performing balloon angioplasty followed by delivery of a stent without removing the catheter from the patient's body. In one embodiment, a balloon placed near the catheter's distal end is first used for pre-dilatation of a vascular stenosis. The catheter is then advanced until a stent placed within a stent containment cavity located just proximal to the balloon is placed within the dilated stenosis. An outer sheath is then pulled back which allows a self-expanding stent to be deployed radially outward. The balloon is then pulled back inside the stent and reinflared to embed the stent into the dilated stenosis. An alternative embodiment of the invention uses a side opening in the catheter located just proximal to the stent containment cavity as an entry port for a flexible guide wire thus providing a "rapid exchange" capability for the integrated catheter.
摘要翻译： 单个整合的导管能够执行气囊血管成形术，随后输送支架而不从患者身体移除导管。 在一个实施例中，放置在导管远端附近的气囊首先用于血管狭窄的预扩张。 然后将导管推进到放置在位于气囊附近的支架容纳腔内的支架置于扩张的狭窄内。 然后将外护套拉回，这允许自扩张支架径向向外展开。 然后将气囊拉回到支架内并重新张开以将支架植入扩张的狭窄。 本发明的替代实施例使用位于刚好靠近支架容纳腔的导管中的侧开口作为柔性引导线的入口，从而为集成导管提供“快速交换”能力。
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公开(公告)号：US5730698A
公开(公告)日：1998-03-24
申请号：US437400
申请日：1995-05-09
CPC分类号： A61F2/86 , A61F2/958 , A61N5/1002 , A61F2220/0033 , A61F2230/005 , A61N2005/1004 , A61N2005/1021
摘要： An expandable temporary stent system (10) is provided for creating a temporary stent within a vessel of a human body and includes an over-the-wire balloon angioplasty catheter (20) having a central lumen (26) and a distal section having an inflatable balloon (23). The balloon angioplasty catheter (20) has a proximal section that remains outside the body. A stent assembly (30) is slidably mounted on the balloon angioplasty catheter (20) in a coaxial manner and has a proximal section as well as a distal section where a temporary stent (31) is located at the distal section. The distal end of the stent assembly (30) is fixed to the distal section of the balloon angioplasty catheter (20). The proximal end of the temporary stent (31) is fixed to a distal end of a pusher tube (32). The pusher tube (32) cooperates with the proximal section of the balloon angioplasty catheter (20) and allows the temporary stent (31) to be reversibly deployed in a radial outward manner responsive to inflation of the balloon and, retracted so that the temporary stent (31) reforms around the balloon (23) of the balloon angioplasty catheter (20) for providing blood flow through the vessel and removal of the system from the vessel of the human body.
摘要翻译： 提供了可扩张的临时支架系统（10），用于在人体的容器内产生临时支架，并且包括具有中心腔（26）和远侧部分的线上球囊血管成形术导管（20） 气球（23）。 球囊血管成形术导管（20）具有保留在体外的近端部分。 支架组件（30）以同轴方式可滑动地安装在球囊血管成形术导管（20）上，并且具有近端部分以及远端部分，其中临时支架（31）位于远端部分。 支架组件（30）的远端固定到球囊血管成形术导管（20）的远端部分。 临时支架（31）的近端固定在推动管（32）的远端。 推动管（32）与球囊血管成形术导管（20）的近端部分协作，并允许临时支架（31）以径向向外的方式可逆地展开，以响应气囊的膨胀并且缩回，使得临时支架 （31）围绕球囊血管成形术导管（20）的球囊（23）周围进行改造，用于提供通过血管的血液流动并将系统从人体血管中移出。
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公开(公告)号：US5697971A
公开(公告)日：1997-12-16
申请号：US661562
申请日：1996-06-11
CPC分类号： A61F2/856 , A61F2/91 , A61F2/915 , A61F2002/91558
摘要： The present invention is a multi-cell stent having at least two different types of cells with each type of cell accomplishing a different purpose. For example, a first type of cell is intended to provide a maximum radial rigidity after stent deployment. A second type of cell is designed to provide increased longitudinal flexibility prior to stent deployment and after stent deployment into a main artery, the second type of cell can be readily balloon expanded at the ostium of a side branch artery to a comparatively large diameter without breaking any of the struts of the stent cell. By this technique, unobstructed blood flow into the side branch can be provided.
摘要翻译： 本发明是具有至少两种不同类型的细胞的多细胞支架，每种类型的细胞实现不同的目的。 例如，第一类型的细胞旨在在支架展开之后提供最大径向刚度。 第二种类型的细胞被设计成在支架展开之前和在支架展开到主动脉之后提供增加的纵向柔性，第二类型的细胞可以容易地在侧支动脉的口处膨胀到相对较大的直径而不破裂 支架细胞的任何支柱。 通过这种技术，可以提供进入侧枝的畅通无阻的血液。
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公开(公告)号：US5242414A
公开(公告)日：1993-09-07
申请号：US926277
申请日：1992-08-10
CPC分类号： A61M25/09041 , A61M5/158 , Y10S604/90
摘要： An ergonomic vascular access needle (10) is provided which has a transparent body (20) having an extended and small diameter capillary lumen (22) through which blood may be observed. The extended capillary lumen (22) is in fluid communication on opposing ends with a variable volume chamber (25) and a needle lumen (32). A movable plunger (40) within the transparent body (20) is displaceable to create the variable volume chamber (25). The distal end of the needle (30) is then pushed through the patient's skin and the plunger (40) is displaced from a forward position to create a suction within the capillary lumen (22), the needle lumen (32) and the variable volume chamber (25). The needle (30) is then advanced until the needle distal opening (33) is within the venous lumen and blood is observable in the capillary lumen (22). A guide wire (50) is then advanced through a lumen (42) of the plunger (40) which causes a plug (47) to be pushed into the variable volume chamber (25) and a guide wire (50) is then advanced into the venous lumen. In this manner, the guide wire (50) may be inserted into the venous lumen without external squirting of the blood.
摘要翻译： 提供符合人体工程学的血管通路针（10），其具有透明体（20），该透明体具有延伸和小直径的毛细血管腔（22），血液可通过所述透明体观察。 扩张的毛细管腔（22）在相对的端部处与可变容积腔（25）和针管腔（32）流体连通。 透明体（20）内的活动柱塞（40）可移动以产生可变体积腔（25）。 然后将针（30）的远端推过病人的皮肤，柱塞（40）从前进位置移位，以在毛细管内腔（22），针腔（32）和可变体积 室（25）。 然后针（30）前进直到针远端开口（33）在静脉内腔内，血液可以在毛细血管内腔（22）中观察到。 然后，引导线（50）通过柱塞（40）的内腔（42）前进，导致插头（47）被推入可变容积室（25）中，然后导丝（50）进入 静脉内腔。 以这种方式，可以在不进行外部喷射血液的情况下将导丝（50）插入静脉内腔。
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公开(公告)号：US08265740B2
公开(公告)日：2012-09-11
申请号：US12457190
申请日：2009-06-03
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0006 , A61B5/0031 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/7465 , A61B2560/0209 , A61N1/3627 , A61N1/3702
摘要： Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.
摘要翻译： 公开了一种用于检测心脏事件的系统，其包括称为心脏切除器，医生程序员和外部警报系统的植入装置。 该系统旨在提供心脏事件的早期检测，例如由心率增加或运动引起的急性心肌梗死或运动诱发的心肌缺血。 如果检测到心律失常，该系统还可以警告患者不太紧急的警报。 使用不同的算法，心脏检查器可以在发生后五分钟内检测到指示心脏事件的患者电描记图的变化，然后自动向患者发出事件发生。 为了提供此警告，系统包括在心电图的ST段超过预设阈值之后激活的心律师内部的内部报警子系统（内部报警装置）和/或外部报警系统（外部报警装置）。
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公开(公告)号：US07860559B2
公开(公告)日：2010-12-28
申请号：US11812826
申请日：2007-06-22
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
IPC分类号： A61N1/00
CPC分类号： A61B5/0464 , A61B5/0006 , A61B5/0031 , A61B5/02455 , A61B5/04012 , A61B5/042 , A61B5/0432 , A61B5/0452 , A61B5/0456 , A61B5/046 , A61B5/0472 , A61B5/686 , A61B5/746 , A61B5/7465 , A61N1/3702 , A61N1/37258 , A61N1/3756 , G16H40/67
摘要： Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.
摘要翻译： 公开了一种用于检测心脏事件的系统，其包括称为心脏切除器，医生程序员和外部警报系统的植入装置。 该系统旨在提供心脏事件的早期检测，例如由心率增加或运动引起的急性心肌梗死或运动诱发的心肌缺血。 如果检测到心律失常，该系统还可以警告患者不太紧急的警报。 使用不同的算法，心脏检查器可以在发生后五分钟内检测到指示心脏事件的患者电描记图的变化，然后自动向患者发出事件发生。 为了提供此警告，系统包括在心电图的ST段超过预设阈值之后激活的心律师内部的内部报警子系统（内部报警装置）和/或外部报警系统（外部报警装置）。
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公开(公告)号：US20100087745A1
公开(公告)日：2010-04-08
申请号：US12585861
申请日：2009-09-28
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson , Bruce Hopenfeld , Michael Sasha John
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson , Bruce Hopenfeld , Michael Sasha John
IPC分类号： A61B5/0452
CPC分类号： A61B5/0456 , A61B5/0006 , A61B5/0031 , A61B5/0452 , A61B5/046 , A61B5/0464 , A61B5/7465 , A61B2560/0209 , A61N1/3627 , A61N1/3702
摘要： A system for the detection of cardiac events occurring in a human patient is provided. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal and a patient alarm means is further provided and electrically coupled to the electrical signal processor. The electrical signal is acquired in the form of electrogram segments, which are categorized according to heart rate, ST segment shift and type heart rhythm (normal or abnormal). Baseline electrogram segments are tracked over time.
摘要翻译： 提供了一种用于检测在人类患者中发生的心脏事件的系统。 系统中包括至少两个电极，以从患者的心脏获得电信号。 电信号处理器电耦合到电极以处理电信号，并且还提供患者报警装置并电耦合到电信号处理器。 电信号是以心律，ST段移位和心律（正常或异常）分为心电图段的形式获得的。 基线电描绘片段随时间跟踪。
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公开(公告)号：US07169174B2
公开(公告)日：2007-01-30
申请号：US10771181
申请日：2004-02-03
IPC分类号： A61F2/06
CPC分类号： A61F2/915 , A61F2/91 , A61F2002/91508 , A61F2002/91516 , A61F2002/91525 , A61F2002/91533 , A61F2002/91541 , A61F2002/91558 , A61F2002/91575 , A61F2002/91583
摘要： The present device has increased longitudinal flexibility in a stent by having some curved sections of each circumferential set of strut members being unconnected to the curved sections of the adjacent circumferential set of strut members with the other curved sections being connected by highly flexible, undulating longitudinal connecting links. The present device prevents flaring of the unconnected strut members by having a shorter longitudinal length for the unconnected strut members, and may have generally shorter longitudinal lengths for all the strut members in the circumferential sets of strut members at the stent ends to reduce the tendency for end flaring of the stent. Finally, the stent demonstrates that the flexible longitudinal connecting links of the curved sections of the sets of strut members are connected at a point that is close to the line where the diagonal sections join the curved sections, thus further reducing the propensity for end flaring.
摘要翻译： 本装置通过使每个圆周组的支柱构件的一些弯曲部分与相邻的圆周组支撑构件的弯曲部分未连接，而其他弯曲部分通过高柔性，起伏的纵向连接 链接。 本装置通过对未连接的支柱构件具有较短的纵向长度来防止未连接的支柱构件的扩口，并且对于在支架端部处的圆柱形构件的圆周组中的所有支柱构件可以具有通常较短的纵向长度，以减少 支架末端扩张。 最后，支架表明，支柱构件组的弯曲部分的柔性纵向连接部分在靠近对角部分连接弯曲部分的线处连接，从而进一步降低了端部扩口的倾向。
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公开(公告)号：US06985771B2
公开(公告)日：2006-01-10
申请号：US10051743
申请日：2002-01-22
IPC分类号： A61B5/04
CPC分类号： A61B5/6865 , A61B5/0006 , A61B5/0031 , A61B5/0452 , A61B5/076 , A61B5/1112 , A61B5/4839 , A61B2505/01 , A61B2560/0462 , A61B2562/0209 , A61M39/0208 , A61M2025/0076 , A61M2039/0226 , A61M2205/18 , A61M2205/3523 , A61M2205/3584 , A61M2230/04
摘要： Disclosed is a system for detecting an acute myocardial infarction (i.e., a heart attack) at the earliest possible time and promptly warning the patient that he should immediately seek medical care. The present invention includes an implantable electronic system that can sense a change in the patient's electrogram that is indicative of a heart attack. If a heart attack is sensed, the device would then cause an implantable and/or externally located alarm to be actuated to warn the patient of his condition and a medical practitioner at a remote diagnostic center would receive the patient's electrogram for analysis. The patient or a caretaker would then be informed to self-inject medication through a subcutaneous, pass-through drug port that can be a separate device or integrated into the implanted device that is designed for the early detection of a heart attack. Since an implantable heart pacemaker or defibrillator already has within its structure many of the elements required for the device to recognize a heart attack, it would be expeditious to add a capability to these existing devices to detect a heart attack, have a pass-through drug port and provide an implantable and/or external alarm means to inform the patient to take appropriate action.
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公开(公告)号：US06609023B1
公开(公告)日：2003-08-19
申请号：US10251505
申请日：2002-09-20
IPC分类号： A61B50452
CPC分类号： A61B5/02455 , A61B5/0031 , A61B5/04012 , A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0468 , A61B5/0472 , A61B5/746 , A61B5/7465 , A61B2560/0209
摘要： Heart disease is the leading cause of death in the United States. A heart attack (also known as an Acute Myocardial Infarction (AMI)) typically results from a thrombus that obstructs blood flow in one or more coronary arteries. The extent of damage to the myocardium from an AMI is strongly dependent upon the length of time prior to restoration of blood flow to the heart muscle. Acute myocardial infarction and ischemia may be detected from a patient's electrocardiogram (ECG) by noting an ST segment shift (i.e., voltage change) over a relatively short (less than 5 minutes) period of time. The present invention is a guardian system including electrodes, a cardiosaver device having AMI detection capability and an alarm means to warn the patient that they have had an AMI or other serious cardiac event and should immediately seek medical attention. Such a warning would facilitate getting medical treatment quickly to restore blood flow to the patient's heart muscle. The present invention provides accuracy of detection by comparing a recently collected electrogram data with baseline electrogram data collected at an earlier time when the heart signals were normal. False positives are reduced by requiring multiple detections separated by a predetermined time interval. The present invention can identify and differentiate between an acute myocardial infarction, exercise induced ischemia and other anomalous cardiac conditions. In the preferred embodiment of the present invention the electrodes and the cardiosaver are implanted and the guardian system includes an external alarm system that can produce an external alarm signal and also has means to turn off the alarm.
摘要翻译： 心脏病是美国的主要死亡原因。 心脏病发作（也称为急性心肌梗死（AMI））通常是由阻塞一个或多个冠状动脉血流的血栓引起的。 AMI对心肌的损伤程度很大程度上取决于恢复血液流向心脏肌肉之前的时间长短。 通过在相对较短（少于5分钟）的时间段内注意ST段移位（即，电压变化），可以从患者的心电图（ECG）中检测到急性心肌梗塞和局部缺血。 本发明是一种监视系统，包括电极，具有AMI检测能力的心脏保护器装置和警告装置，用于警告患者已经患有AMI或其他严重的心脏事件，并且应该立即就医。 这样的警告将有助于迅速治疗以恢复患者心脏肌肉的血流。 本发明通过将最近收集的电描记图数据与当心脏信号正常的较早时间收集的基线电图数据进行比较来提供检测的准确性。 通过要求以预定时间间隔分开的多个检测来减少假阳性。 本发明可以鉴别和区分急性心肌梗死，运动性诱导的缺血和其他异常心脏病状。 在本发明的优选实施例中，植入电极和心脏保护器，并且监护系统包括可产生外部报警信号的外部报警系统，并且还具有关闭报警的装置。
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